{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T15:49:38Z","timestamp":1791215378757,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,10,4]],"date-time":"2024-10-04T00:00:00Z","timestamp":1728000000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gen and Family Med"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Chronic periodontal disease primarily causes tooth loss and oral frailty and is linked to chronic conditions such as diabetes mellitus. However, its progression and broader studies on chronic diseases have not been well explored. This study aimed to investigate this association using claims data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective cohort study used linked medical, dental, and pharmacy claims data from a local municipality in Japan. The study included participants aged 40\u201370\u2009years who had received medical care between April 2017 and March 2018. Exposures included age, sex, and common chronic diseases previously reported to be associated with periodontal diseases (21 diseases). We defined the outcome, \u201cprogression of severe periodontitis\u201d as the worsening of periodontal disease to a severe stage requiring surgery or tooth extraction, determined by the presence of a periodontal surgery code or a deeper probing pocket depth (\u22656\u2009mm) code along with the tooth extraction procedure code. The participants were followed up until March 2022, and multivariate analysis was conducted using Cox proportional hazard models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 28,846 participants, 1035 (3.6%) progressed to severe periodontal disease. In the multivariate analysis, only diabetes mellitus was significantly associated with severe periodontal disease, with a hazard ratio of 1.26 (95% confidence interval, 1.08\u20131.53) among all chronic diseases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patients with diabetes mellitus had a high risk of severe periodontal disease progression, suggesting that proactive dental visits should be recommended to prevent severe periodontal disease.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jgf2.734","type":"journal-article","created":{"date-parts":[[2024,10,4]],"date-time":"2024-10-04T13:10:30Z","timestamp":1728047430000},"page":"54-64","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Association between chronic diseases and severe periodontal disease progression: A retrospective cohort study in a city of Japan"],"prefix":"10.1002","volume":"26","author":[{"given":"Sayaka","family":"Nin","sequence":"first","affiliation":[{"name":"Graduate School of Comprehensive Human Sciences University of Tsukuba  Ibaraki Japan"},{"name":"Department of Primary Care and Medical Education, Institute of Medicine University of Tsukuba  Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3784-4333","authenticated-orcid":false,"given":"Yu","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Primary Care and Medical Education, Institute of Medicine University of Tsukuba  Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takami","family":"Maeno","sequence":"additional","affiliation":[{"name":"Department of Primary Care and Medical Education, Institute of Medicine University of Tsukuba  Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chihiro","family":"Nishiura","sequence":"additional","affiliation":[{"name":"Department of Primary Care and Medical Education, Institute of Medicine University of Tsukuba  Ibaraki Japan"},{"name":"Wako Human Resources Section RIKEN  Wako Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kento","family":"Taira","sequence":"additional","affiliation":[{"name":"Health Services Research and Development Center University of Tsukuba  Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Fujimoto","sequence":"additional","affiliation":[{"name":"Occupational Health Data Science Center University of Occupational and Environmental Health  Kitakyushu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0304-9881","authenticated-orcid":false,"given":"Jun","family":"Hamano","sequence":"additional","affiliation":[{"name":"Institute of Medicine University of Tsukuba  Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0583-2917","authenticated-orcid":false,"given":"Sachiko","family":"Ozone","sequence":"additional","affiliation":[{"name":"Department of Primary Care and Medical Education, Institute of Medicine University of Tsukuba  Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuhiro","family":"Maeno","sequence":"additional","affiliation":[{"name":"Department of Primary Care and Medical Education, Institute of Medicine University of Tsukuba  Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,10,4]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2020.07.023"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.2012.01910.x"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/jre.12300"},{"key":"e_1_2_8_5_1","unstructured":"Ministry of Health Labour and Welfare.Summary of the dental disease survey results (in Japanese).2022. 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